Meltem Sertbaş

Fatih Sultan Mehmet Eğitim Ve Araştırma Hastanesi

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Ali Ozdemır

Fatih Sultan Mehmet Waqf University

Yaşar Sertbaş

Fatih Sultan Mehmet Eğitim Ve Araştırma Hastanesi

Nalan Okuroğlu

University of Health Science

Seda Sancak

Kent Hastanesi

Sabiha Kömoğlu

University of Health Science

A. D. Dayan

Haydarpaşa Numune Eğitim ve Araştırma Hastanesi

Müzeyyen Eryılmaz

Fatih Sultan Mehmet Eğitim Ve Araştırma Hastanesi

Birgul Ozen

Fatih Sultan Mehmet Eğitim Ve Araştırma Hastanesi

Ozden Ezgi Uner

Fatih Sultan Mehmet Eğitim Ve Araştırma Hastanesi

Mehmet Akif Öztürk

Gazi University

Cooperative Institutions

Sağlık Bilimleri Üniversitesi

Fatih Sultan Mehmet Eğitim Ve Araştırma Hastanesi

University of Health Science

Universidad CES

Yedikule Teaching Hospital

University of Health Sciences

Chest Diseases Hospital

University of Health Sciences Antigua

Ankara Atatürk Göğüs Hastalıkları Ve Göğüs Cerrahisi Eğitim Ve Araştırma Hastanesi

Ministry of Health

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First exercise reports of diabetes center in Turkey: effects of exercise on metabolic parameters in patients with type-2 diabetes mellitus

Medicina dello Sport (2021)

Yaşar Sertbaş Ozden Ezgi Uner Meltem Sertbaş Emre ŞENOCAK Rahime Gozkan

BACKGROUND: The current study aimed to show the efficacy of the exercise program performed by the type-2 diabetic patients in the exercise center related to the diabetes clinic.METHODS: This was a retrospective study, conducted on 77 (18-65 years old) diabetic patients who were attending the exercise center of the outpatient diabetes clinic. Patients who completed 3 months of supervised combined exercise program and having no chronic drug adjustment for 3 months at the beginning and during the exercise interval were recruited to the study.RESULTS: After 3 months, supervised combine exercise program, there were significant improvement of BMI (34.62 vs. 33.14 kg/m2, P<0.001), fat mass (34.95 vs. 33.83 kg, P<0.001), fasting blood glucose (124.59 vs. 117.39 mg/dL, P=0.015), HbA1c (6.74 vs. 6.45, P<0.001), and triglyceride levels (177.78 vs. 167.50 mg/dL, P=0.038).CONCLUSIONS: In conclusion, as a real-life data the supervised combine exercise program, performed in the exercise center of the diabetes clinic, significantly improved the metabolic parameters of the patients. We believe that diabetes clinics should include exercise centers, which are controlled by experts, to provide more qualified management for diabetic patients.

Outpatient clinic

Physical exercise

10.23736/s0025-7826.21.03792-3

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Lens autofluorescence ratio as a noninvasive marker of peripheral diabetic neuropathy

Polskie Archiwum Medycyny Wewnętrznej (2019)

Meltem Sertbaş Yaşar Sertbaş Ozden Ezgi Uner Serkan Elarslan Nalan Okuroğlu

INTRODUCTION Diabetes and its complications are the significant cause of morbidity and mortality. Advanced glycation end products play a major role in the pathogenesis of diabetes complications. OBJECTIVES The aim of the study was to investigate the possible use of a biomicroscope (ClearPath DS‑‑120), which shows the age‑‑adjusted lens fluorescence ratio (LFR), for the diagnosis of diabetic peripheral neuropathy (DPN). PATIENTS AND METHODS A total of 160 patients with type 2 diabetes who underwent an LFR measurement were recruited to this study. DPN was defined as the presence of neuropathic pain or feet sensory loss (or both). Neurothesiometer, monofilament test, and DN4 test results were used for the diagnosis of DPN. RESULTS The LFR of 43 patients (27%) was higher than the expected levels. According to the DN4 questionnaire, 35 of 160 patients (21%) had neuropathic pain. Thirty‑‑seven patients (23%) had higher vibration perception thresholds than expected (>25 V). The monofilament test showed that 42 patients (26%) seemed to be affected by DPN. All of the tests, when considered individually, revealed that patients with higher LFR had more problems related to DPN (P <0.05). High LFR had a sensitivity of 50% and a specificity of 81% in the diagnosis of DPN. Although there was no significant difference in fasting blood glucose levels, we observed that HbA1c levels were higher and diabetes duration was longer in patients with higher LFR (P <0.05). CONCLUSIONS The measurement of LFR may have clinical utility for a noninvasive detection of DPN.

Diabetic Neuropathy

10.20452/pamw.4449

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Assesment of Psychiatric Symptoms and Co-morbidities in Patients with Irritable Bowel Syndrome

West Indian Medical Journal (2012)

Yaşar Sertbaş Hasan Belli Nezih Pişkinpaşa Cenk Ural Mahir Akbudak

To determine the psychiatric symptom assessment of patients seeking treatment for irritable bowel syndrome (IBS) and to demonstrate the presence of more complicated psychiatric disorders.The participants were recruited from patients who were attending internal medicine and gastroenterology clinics and who fullfilled the Rome III criteria for IBS. Fifty patients with IBS (IBS group) and 50 patients with complaints other than gastrointestinal symptoms (control group) were randomly selected. All participants were screened by the Structured Clinical Interview for DSM-IV (SCID-I), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Check list - 90 (Revised) [SCL-90-R].Seventeen patients (34%) and three control subjects (6%) had at least one psychiatric diagnosis (p = 0.001). Global severity index (GSI) total scores and SCL-90-R items were significantly higher in the IBS group than the control group (0.92 +/- 0.46 vs 0.358 +/- 0.19, p < 0.001). Beck anxiety inventory and BDI scores were higher in the IBS group than the control group (p < 0.001). Axis-I psychiatric disorders diagnosed with SCID-I were significantly higher in the IBS group (34% vs 6%) [p = 0.001]. Among the Axis-I disorders, somatoform and anxiety disorders were higher in the patient group than in the control subjects (p = 0.002 and p = 0.0057) whereas there was no difference for mood disorders (p = 0.204). Seven (14%) of the patients and two (4%) of the control subjects had at least one Axis-II psychiatric disorder diagnosed with SCID-II without any significance (p = 0.159).These findings suggest that except for mood and personality disorders, almost all psychiatric symptoms and disease co-morbities with IBS are higher than in the sample without IBS. We can easily use SCL-90-R, BAI and BDI in internal medicine and gastroenterology clinics to detect psychiatric symptom levels and then to refer patients to a psychiatrist for further evaluation and treatment.

Beck Anxiety Inventory

Depression

10.7727/wimj.2012.166

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Normalization of serum TSH doesn’t represent true euthyroidism for patients on levothyroxine treatment

Journal of the Pakistan Medical Association (2022)

Nalan Okuroğlu Elif Sakçı Meltem Sertbaş Yaşar Sertbaş Seda Sancak

Introduction: To evaluate whether normalisation of serum thyroid-stimulating hormonelevels with levothyroxine is related with metabolic parameters and psychologic wellbeing. Method: The observational, case-control study was conducted from to May to July 2019 in the outpatient thyroid clinics of Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey, and compried hypothyroid patients in the euthyroid state with levothyroxine treatment and euthyroid controls. Psychological wellbeing was assessed using the General Health Questionnaire-12, and metabolic parameters with lipid levels and body composition were analysed for both the groups. Data was analysed using SPSS 25. Results: Of the 159 subjects, 110(69%) were case with a mean age of 50.1±11.7 years, and 49(31%) were controls with a mean age of 47.3±15.2 years. There was no significant difference related to thyroid-stimulating hormonel levels between the groups (p=0.191). Free throxine levels were significantly higher in the cases, while free triiodothyroinine levels were higher in the controls (p<0.001). Total cholesterol and triglycerides levels were significantly higher in the cases than the controls (p<0.05). The cases had lower basal metabolic rate and fat free mass than the controls, but the difference was not significant (p>0.05). The cases scored higher in terms of wellbeing than the controls, but the difference was not significant (p>0.05). Conclusion: Thyroid hormone replacement needs to be adjusted to provide a satisfactory treatment for hypothyroid patients with normal thyroid-stimulating hormone levels who remain clinically and biochemically asymptomatic. In symptomatic patients, peripheral parameters of hypothyroidism, such as lipid levels, ---Continue

Levothyroxine

Outpatient clinic

Thyroid-stimulating hormone

10.47391/jpma.0588

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Myocardial injury and acute renal failure associated with lactic acidosis due to suicide attempt with metformin.

PubMed (2016)

Meltem Sertbaş Yaşar Sertbaş Özgür Ordu Enver Berber Birgul Ozen

Metformin-associated lactic acidosis (MALA) is one of the most important drug toxicities with a high morbidity and mortality rate. We report herein a case of suicide attempt with metformin presenting as MALA and acute renal failure on admission to emergency department and acute myocardial injury later on hospitalisation. An obvious improvement of metabolic parameters was seen in our patient provided by anti-ischaemic treatment together with bicarbonate infusion and haemodialysis. Although myocardial injury due to MALA is not a common disorder, we must be aware that metformin overdose with lack of tissue oxygenation, hypoperfusion, and arrhythmias may cause myocardial ischaemia.

Lactic acidosis

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The role of ultrasound in determining the presence and severity of carpal tunnel syndrome in diabetic patients

Journal of Investigative Medicine (2023)

Yaşar Sertbaş Nimet Dörtcan Esin Derin Çiçek Meltem Sertbaş Nalan Okuroğlu

Carpal tunnel syndrome (CTS) is seen in 5% of the population and 14%–30% in diabetics. Although electrophysiological tests are used as the gold standard method in the diagnosis, alternative methods are being studying. We aimed to investigate whether the measurement of median nerve cross-sectional area (CSA) by ultrasound is associated with the presence and severity of CTS. This prospective, cross-sectional observational study includes 128 randomly selected T2DM patients. Electrodiagnostic study was performed for all patients to diagnose CTS. Median nerve CSA were measured with ultrasound examination. The severity of the CTS was determined by Padua method. Among 128 diabetes mellitus (DM) patients, 54 (28%) had CTS and 53 (41%) had diabetic peripheral polyneuropathy. The mean duration of DM was 11.55 years. Median nerve CSAs of the patients were significantly higher in patients with CTS (CTS (−): 10.47 ± 2.67 vs CTS: (+) 12.37 ± 3.17; p < 0.001). Median nerve CSA cutoff value of >10 mm 2 predicts the diagnosis of CTS. However, minimal, mild, and moderate CTS groups had similar CSA according to Padua classification (p > 0.05 for all). CSA measurement with ultrasonography can be used as an effective method in diagnosing severe CTS disease. However, median nerve CSA values should not be used to reveal the severity of CTS, in order not to miss the demonstration of minimal, mild, and moderate groups, as well as being an indicator of only the severe CTS group.

Gold standard (test)

10.1177/10815589231167360

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Mean platelet volume changes before and after glycated hemoglobin (HbA 1c ) improvement in a large study population

Archives of Medical Science (2016)

Yaşar Sertbaş Meltem Sertbaş Nalan Okuroğlu Mehmet Akif Öztürk K. Abacar

Diabetes mellitus (DM) is a metabolic disorder associated with both microvascular and macrovascular complications. Mean platelet volume (MPV) is a marker of platelet activity, which plays a major role in the development of vascular complications of DM. The aim of this study is to compare the MPV levels before and after the decrease of glycated hemoglobin (HbA1c) levels in a large diabetic population.This was a retrospective study conducted on type 2 diabetic patients from the outpatient clinic for 1 year between 2014 and 2015 with the participation of 595 diabetic patients.When we compared the basal and post-treatment values, a significant decrease of MPV and HbA1c levels was found (HbA1c: 9.41 ±1.98% vs. 7.43 ±1.29%, p < 0.001; MPV: 9.11 ±1.42 vs. 8.17 ±1.04, p < 0.001). There was also a positive correlation between the mean changes of MPV and HbA1c levels after the treatment (ΔMPV: 0.93 ±0.96 vs. ΔHbA1c: 1.96 ±1.43; p = 0.005, r = 0.115). When the participants were divided into two groups according to their basal HbA1c levels (group A: HbA1c ≤ 6.5% and group B: HbA1c > 6.5%), it was clearly seen that improvement of glucose levels led to a significant decrease in MPV levels in both groups.The results of this study show that better glycemic control is associated with a significant decrease of MPV levels, regardless of whether the treatment modality is insulin or oral antidiabetic.

Mean platelet volume

Glycated hemoglobin

Basal (medicine)

10.5114/aoms.2016.61900

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Citations (13)

Relationship between Metabolic Syndrome Components and COVID-19 Disease Severity in Hospitalized Patients: A Pilot Study

Canadian Journal of Infectious Diseases and Medical Microbiology (2022)

Hande Erman Banu Böyük Meltem Sertbaş Ali Ozdemır

Preliminary data suggest that patients with comorbidities are more susceptible to severe COVID-19 infection. However, data regarding the presence of metabolic syndrome (MetS) in patients with COVID-19 are scarce.In the present study, we aim to investigate the association between MetS components and disease severity in hospitalized COVID-19 patients.We conducted a prospective observational study of 90 hospitalized patients with COVID-19 pneumonia at a tertiary hospital. The study population consisted of inpatients who tested positive by the reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. Patients with critical COVID-19 disease on admission were excluded. Adult Treatment Panel III of the National Cholesterol Education Program (NCEP-ATP III) criteria were used to define MetS. Laboratory analysis and thorax CT were performed on admission.90 patients, 60 moderate and 30 severe COVID-19 patients, included in the study. The percentage of MetS cases was higher among severe COVID-19 patients (p=0.018). Of the MetS criteria fasting blood glucose (p=0.004), triglycerides (p=0.007) were significantly higher in patients with severe COVID-19 disease with no statistical significance found in waist circumference (WC) (p=0.348), systolic blood pressure (p=0.429), and HDL-C levels (p=0.263) between two groups. Body mass index (BMI) values were similar in both severe and moderate cases (p=0.854). In logistic regression analysis, serum triglycerides (p=0.024), HDL-C (p=0.006), and WC (p=0.004) were found as independent prognostic factor for severe COVID-19 infection.Severe COVID-19 patients have higher rates of MetS. Serum triglycerides, HDL-C, and WC have an impact on disease severity in COVID-19.

Population study

10.1155/2022/9682032

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Association of blood groups on the risk of COVID 19 infection, morbidity and mortality

Northern Clinics of Istanbul (2021)

Meltem Sertbaş

T he novel coronavirus-19 disease (COVID-19) due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus was first reported in Wuhan, China, in December 2019 [1].Since then, it has spread throughout the World with significant morbidity and mortality.In March 2020, the World Health Organization (WHO) reported COVID-19 as a pandemic and, over time, reported 110749023 confirmed cases of infection and 2455131 deaths until February 22, 2021 [2].Due to the high morbidity and mortality associated with ABSTRACT OBJECTIVE: We aimed to compare the effects of blood groups and Rh factor on the development of coronavirus-19 disease (COVID-19) with all aspects such as clinical course, inflammatory parameters, and organ-specific biochemical parameters with a significant number of patients.METHODS: This multicenter study was carried out retrospectively on 3551 patients hospitalized with the diagnosis of COVID-19 and whose blood groups were recorded during the time of hospitalization.As control groups, 22133 individuals' medical data who were admitted to the blood bank affiliated with our hospitals during the last year was used.The differences between the blood groups and clinical characteristics were analyzed. RESULTS:Of the 3551 patients, A Rh (+) blood group was found to be in a higher ratio in the case group than controls, with increased risk to be infected (case: 41.3% vs. control: 38.8%), (OR 1.113; p=0.003).Meanwhile O Rh (+) blood group ratios were significantly lower in the case group than in the control group (case: 26% vs. control: 28.3%) (OR 0.862; 95% CI: 0.823-0.966;p=0.005).There was no significant difference between blood groups in terms of admission to the intensive care units and mortality, it was observed that patients with AB Rh (+) blood group have a greater risk for intubation than others (OR: 1.467; 95% CI: 1.040-2.071;p=0.028). CONCLUSION:We demonstrated that people with blood group A Rh (+) more susceptible to COVID-19, whereas blood group 0 Rh (+) have a protective effect against the infection.Once a person has been infected with severe acute respiratory syndrome coronavirus 2, we should be mindful that patients with blood group AB Rh (+) would be prone to intubation more than other blood groups.

Pandemic

Coronavirus

10.14744/nci.2021.91328

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Treatment of Chronic Hepatitis C Can Improve Glycemic Control in Patients with Type 2 Diabetes

Case Reports in Hepatology (2018)

Nalan Okuroğlu Meltem Sertbaş Ali Ozdemır

A 73-year-old female patient with a history of type 2 DM for seven years was admitted to our out-patient clinic with a complaint of frequent hypoglycemic episodes. She was receiving basal- bolus insulin treatment. She underwent liver transplantation 20 months ago due to end stage liver disease caused by HCV infection genotype 1b. While she was still on tacrolimus for liver transplantation, she received direct acting antiviral agents including fix dose ledipasvir-sofosbuvir with ribavirin. Biochemical analysis showed fasting plasma glucose of 105 mg/dl and postprandial glucose of 200 mg/dl, glycosylated hemoglobin A1c of 4.8%, and c-peptide of 3.17 ng/ml. After achieving successfully virologic response with antiviral therapy, the patient stayed euglycemic and was no longer in need to any medication including insulin and the patient was followed only by dietary regulation. Achievement of the virological response in treatment of HCV infection can improve not only the liver status, but also the extrahepatic manifestations including type 2 DM.

Sofosbuvir

Ledipasvir

Hepatitis C

Liver disease

Daclatasvir

10.1155/2018/5260510

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Citations (3)